Radical radiotherapy in high-risk prostate cancer patients with high or ultra-high initial PSA levels: a single institution analysis.
J Cancer Res Clin Oncol
; 139(7): 1141-7, 2013 Jul.
Article
en En
| MEDLINE
| ID: mdl-23552872
ABSTRACT
PURPOSE:
Purpose of this study is to analyze outcomes and pre-treatment prognostic factors in high-risk prostate cancer patients with initial PSA ≥ 20 ng/mL, treated with high-dose external beam radiotherapy (EBRT) and androgen deprivation therapy (ADT) in a single institution.METHODS:
Between March 2003 and December 2011, 155 consecutive high-risk prostate cancer patients (a) presenting with pre-treatment PSA level ≥ 20 ng/mL, (b) treated with definitive EBRT, and (c) with a minimum follow-up of 24 months were included in this retrospective analysis. Phoenix definition was used to define biochemical control. Primary endpoints were as follows biochemical disease-free survival (bDFS), distant metastasis-free survival (DMFS), cancer-specific survival (CSS) and overall survival (OS). Multivariate analysis was performed to determine the independent prognostic impact of pre-treatment clinical factors [T stage, PSA, and Gleason score (GS)].RESULTS:
At a median follow-up time of 62 months, actuarial bDFS, DMFS, CSS, and OS at 5 years were 64.8, 85.2, 95.8, and 94.4 %, respectively. On multivariate analysis, only GS was significantly associated with three clinical endpoints (bDFS HR 1.6; p = 0.022, CSS HR 4.27, p = 0.044, OS HR 2.6; p = 0.038). Pre-treatment zenith PSA was associated only with bDFS (HR 1.87; p = 0.027).CONCLUSIONS:
Patients with "high" PSA levels (≥ 20 ng/mL) showed favorable clinical outcomes, supporting the role of local radiotherapy as primary therapy in combination with long-term ADT in patients with high PSA levels at diagnosis. A GS of 8-10 is the strongest predictor of outcome.
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Neoplasias de la Próstata
/
Antígeno Prostático Específico
Tipo de estudio:
Etiology_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Límite:
Aged
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Aged80
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
J Cancer Res Clin Oncol
Año:
2013
Tipo del documento:
Article
País de afiliación:
Italia